Pharmacokinetically-guided 5-FU dose optimization within the preoperative folfoxiri regimen in resectable pancreatic cancer patients
Author, Company : Anna Vilalta, University of Navarra, Pamplona, Spain and others
Abstract Number: 4636
Indications : resectable pancreatic cancer (PC)
Interventions : 5-FU, folfoxiri
Background and objectives:
Patients having resectable PC are mostly treated with neoadjuvant therapy. The objective of study was to determine whether 5-FU PK parameters had any correlation with outcomes in resectable PC patients treated with preoperative folfoxiri.
Results from November 2012 to October 2018 for 29 resectable PC patients with preoperative folfoxiri and 5-FU treatment were retrospectively assessed. 5-FU concentrations were analyzed by HPLC in two plasma samples during the infusions in at least two cycles.
Results and observations:
Log-Rank test was performed in this exploratory analysis to examine PFS based on
5-FU AUC values. 29 patients had an R0 resection rate of 90% in the intention-to-treat analysis.
- Grade 3-4 induction polychemotherapy (IPCT) related toxicities and grade 3 (chemoradiation) CRT related toxicities were reported in 40% and 30% of patients, respectively
- Median PFS was 723 days (24 months) and median 5-FU AUC 28.5 mcg*h/ml (23-53)
|5-FU AUC||Median PFS|
|<27 mcg*h/ml||15 months|
(Adjusted hazard ratio for disease progression 0.223)
Longer PFS was observed in patients whose 5-FU PK AUC is ≥ 27mcg*h/ml compared to those whose AUC < 27mcg*h/ml
PK parameter of 5-FU optimizes the folfoxiri regimen by significantly increasing the PFS in resectable PC patients.